Individual provider Active NPI

Brooke A. Mawery, D.P.T.

  • Physical Therapist
  • Geneva, NY
National Provider Identifier
1205233475
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038468-1 Issued in NY
Practice address
515 W Washington St
Geneva, NY 14456-2117
Phone
(315) 781-1010
Fax
(315) 781-1722
NPI assigned
Dec 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 038468-1 NY Primary

Addresses

Primary practice location

515 W Washington St
Geneva, NY 14456-2117

Mailing address

515 W Washington St
Geneva, NY 14456-2117
Phone (315) 781-1010

Other identifiers 1

IdentifierTypeStateIssuer
12778279OtherNYCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529001404 MD Practitioner - Physical Therapist in Private Practice 2860716768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Rehab 2 Perform LLCGroup PAC ID 6002199064, 92 clinicians

Practice addresses (Care Compare)

1750 Forest Dr
Suite 145
Annapolis, MD 21401-4211
Phone (301) 798-4838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038468-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
In Motion Physical Therapy Canandaigua CurrentSince Apr 21, 2024 Accepting new patients

Locations

73 Buffalo St
Ste 300
Canandaigua, NY 14424
Phone (585) 412-6477

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1205233475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562117",
            "telephone_number": "315-781-1010",
            "fax_number": "315-781-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562117",
            "telephone_number": "315-781-1010",
            "fax_number": "315-781-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWERY",
        "first_name": "BROOKE",
        "middle_name": "A.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038468-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12778279",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.